Common brand names:

Summary of Interactions with Vitamins, Herbs, & Foods

Replenish Depleted Nutrients

none

Reduce Side Effects

none

Support Medicine

none

Reduces Effectiveness

none

Potential Negative Interaction

Dan Shen

Dan shen (Salvia miltiorrhiza), a Chinese herb, was associated with increased warfarin activity in two cases. Although warfarin acts differently from ticlopidine, both affect parameters of bleeding. Until more is known, people taking ticlopidine should use dan shen only under close medical supervision. Sage(Salvia officinalis), a plant relative of dan shen found in the West, has not been not associated with interactions involving warfarin.

Ginseng (Panax ginseng) was associated with a decrease in warfarin activity in a case study. This report suggests that ginseng may affect parameters of bleeding. Therefore, people taking ticlopidine should consult with a physician knowledgeable about botanical medicines before taking Asian ginseng or eleuthero/Siberian ginseng (Eleutherococcus senticosus).

Ginseng (Panax ginseng) was associated with a decrease in warfarin activity in a case study. This report suggests that ginseng may affect parameters of bleeding. Therefore, people taking ticlopidine should consult with a physician knowledgeable about botanical medicines before taking Asian ginseng or eleuthero/Siberian ginseng (Eleutherococcus senticosus).

Devil's claw (Harpagophytum procumbens) was associated with purpura (bleeding under the skin) in a patient treated with warfarin. As with dan shen, until more is known, people taking ticlopidine should avoid taking devil's claw concurrently.

Garlic (Allium sativum) has been shown to help prevent atherosclerosis (hardening of the arteries), perhaps by reducing the ability of platelets to stick together. Interfering with the action of platelets results in an increase in the tendency toward bleeding and in theory could dangerously enhance the effect of ticlopidine. Standardized extracts of garlic have been associated with bleeding in people only on rare occasions. People taking ticlopidine should consult with a doctor before taking products containing standardized extracts of garlic or eating more than one clove of garlic daily.

Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding. In a rat study, a high intake of ginkgo increased the action of ticlopidine in a way that could prove dangerous if the same effect occurred in people. Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem. People taking ticlopidine should use ginkgo extracts only under the supervision of a doctor.

Although there are no specific studies demonstrating interactions with platelet inhibitors, the following herbs contain coumarin-like substances that may cause bleeding and therefore interact with ticlopidine. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff.

Like ticlopidine, salicylates interfere with the action of platelets. Various herbs, including meadowsweet(Filipendula ulmaria), poplar (Populus tremuloides),willow(Salix alba), and wintergreen (Gaultheria procumbens) contain salicylates. Though similar to aspirin, plant salicylates have been shown to have different actions in test tube studies. Furthermore, salicylates are poorly absorbed and likely do not build up to levels sufficient to cause negative interactions that aspirin might cause. No reports have been published of negative interactions between salicylate-containing plants and aspirin or aspirin-containing drugs. Therefore concerns about combining salicylate-containing herbs and any drug remain theoretical, and the risk of causing bleeding problems may be low.

Explanation Required

Ginger has been shown to reduce platelet stickiness in test tubes. Although there appear to be no reports of interactions with platelet inhibiting drugs, people should talk with a healthcare professional if they are taking a platelet inhibitor and wish to use ginger.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Healthnotes knowledgebase does not contain every possible interaction.

The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

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